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CASE 3 Chronic Shortness of Breath

 *MDI

http://www.med.umich.edu/1libr/pa/mdinspir.gif

 *JVD

http://www.cuhk.edu.hk/cslc/materials/pclm1011/pclm1011.html

 *MRC dyspnea scale

Patients were asked about their perceived breathlessness and were then classified into MRC dyspnoea grades 3, 4, or 5 according to how they perceived their disability. The MRC dyspnoea scale is a questionnaire that consists of five statements about perceived breathlessness: grade 1, "I only get breathless with strenuous exercise"; grade 2, "I get short of breath when hurrying on the level or up a slight hill"; grade 3, "I walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level"; grade 4, "I stop for breath after walking 100 yards or after a few minutes on the level"; grade 5, " I am too breathless to leave the house". Patients selected the grade that applied to them. Those who graded themselves in MRC grades 3, 4, or 5 were entered into the study as these levels would correspond to moderate to severely disabling COPD. Patients with grades 1 and 2 dyspnoea were excluded from the study.

http://thorax.bmj.com/cgi/content/full/54/7/581

Borg dyspnea scale

Figure 1. Modified Borg scale.

SCALE

SEVERITY

0

No Breathlessness* At All

0.5

Very Very Slight (Just Noticeable)

1

Very Slight

2

Slight Breathlessness

3

Moderate

4

Some What Severe

5

Severe Breathlessness

6

7

Very Severe Breathlessness

8

9

Very Very Severe (Almost Maximum)

10

Maximum

http://www.ac6v.com/karlaz2.htm

COPDは日本だと10

http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/sinno05/13-2-1.html